Colonoscopy in ileocolitis

Abstract

In the evaluation of acute and/or chronic inflammatory conditions of the large intestine, ileocolonoscopy is an established and accurate imaging procedure. The possibility of viewing discrete abnormalities of the mucosa, such as change of color, minute erosions or blurring of the vascular pattern, combined with the possibility of collecting biopsy specimens for histopathological examination and culture, has given endoscopy a great advantage over radiology. Many patients with colitis can be examined well using sigmoidoscopy. There are, however, grounds for colonoscopy in cases of ileocolitis:

• differential diagnosis with other inflammatory conditions of specific origin;

• investigation of inconclusive abnormalities detected by X-ray;

• endoscopic treatment of ileocolonic Crohn’s strictures;

• preoperative and postoperative evaluation;

• the anatomical spread of the disease;

• surveillance for dysplasia and/or malignancy in long-standing colitis;

• evaluation of patients not responsive to standard therapy or establishing etiology for a recent flare-up.